Provider Demographics
NPI:1770043846
Name:RISCH, BRENDA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:ANN
Last Name:RISCH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:DR
Other - First Name:BRENDA
Other - Middle Name:
Other - Last Name:RISCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:2714 WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-3928
Mailing Address - Country:US
Mailing Address - Phone:915-263-4623
Mailing Address - Fax:915-263-4623
Practice Address - Street 1:2714 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-3928
Practice Address - Country:US
Practice Address - Phone:915-263-4623
Practice Address - Fax:915-263-4623
Is Sole Proprietor?:No
Enumeration Date:2019-03-23
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65344104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker